Nursing Elites

1. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

2. A client has a new prescription for Omeprazole. Which of the following statements should the nurse include in teaching the client?

• A. Take the medication before meals.
• B. You may experience a rapid heart rate.
• C. Increase your intake of high-calcium foods.
• D. Expect your urine to turn orange.

Correct answer: A

Rationale: The correct statement for the nurse to include when teaching a client prescribed Omeprazole is to take the medication before meals. Omeprazole, a proton pump inhibitor, is most effective when taken before meals as it works by reducing the amount of acid produced in the stomach. Choice B is incorrect because a rapid heart rate is not a common side effect of Omeprazole. Choice C is incorrect as there is no specific requirement to increase intake of high-calcium foods with Omeprazole. Choice D is also incorrect as Omeprazole does not typically cause urine discoloration.

3. A healthcare professional is teaching a client who has a new prescription for Clopidogrel. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the patient's platelet count is essential because a decrease in platelet count can increase the risk of bleeding. By assessing the platelet count, the healthcare professional can detect any potential adverse effects related to the medication and take appropriate actions to prevent complications. White blood cell count, hemoglobin, and blood glucose levels are not directly affected by Clopidogrel, so they are not the primary values to monitor for potential adverse effects of this medication.

4. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Somnolence. Somnolence can indicate lactic acidosis, a rare but serious adverse effect of Metformin. Lactic acidosis is manifested by extreme drowsiness, hyperventilation, and muscle pain. Clients should be instructed to report these symptoms to their healthcare provider promptly to prevent further complications.

5. At what amount does Acetaminophen stop effectively controlling pain?

• A. Over 1,000 mg
• B. 750 mg
• C. Over 1,500 mg
• D. 150 mg

Correct answer: A

Rationale: Acetaminophen is known to lose its effectiveness in controlling pain beyond a dosage of 1,000 mg. Taking more than 1,000 mg will not provide additional pain relief but can increase the risk of adverse effects. Choice B (750 mg) is incorrect because this amount is within the typical recommended dose range for Acetaminophen. Choice C (Over 1,500 mg) is incorrect as it suggests a higher dose than the point at which Acetaminophen starts to lose its effectiveness. Choice D (150 mg) is too low a dose to effectively control pain for most adults.

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